Evidence Based Practice In Nursing

Evidence-Base practice (EBP) is defined as: “based on problem identified from the practitioner’s area of practice; a combining of best evidence and professional expertise and an integration of this into current practice; about ensuring patients receive quality care, being part of quality improvement processes; about collaboration and requiring a team approach” (French, 1999). Scott and Mcsherry (2008) supported the French’s assertion, proposing the key elements of EBP are that it is a theory-driven process, which involves the use, evaluation and application of research; identification of best evidence; evaluation of care; problem solving; decision-making; clinical expertise; and requires patient involvement. Evidence-based practice is made of evidence, clinical expertise, patient preference, the context of care (Barker, 2013). In brief, evidence-based practice is the parameter in the nursing practice that it requires that the nurses gather and use clinical evidence to make decision for the patients so that in the nursing process they can deliver the quality of care for the patients (Ellis, 2013). In the other words, in the nursing practice all the nursing procedures performed by the clinical evidence supported.

Evidence based practice is an integral part of nursing care. According to the Academy of Medical-Surgical Nurses, evidence based practice is defined as, “the conscientious use of current best evidence in making decisions about patient care.” (AMSN) The use of evidence based practice has drastically improved patient outcomes, increased quality and safety of healthcare, and reduced costs for facilities. (Melnyk, 2016) In this paper I will provide the history of evidence based practice, how it has already been incorporated and impacted healthcare, and why it is important to nursing and healthcare as a whole.

The following literature will define the term, “evidence informed practice”. It will discuss the benefits and limitations of integrating evidence informed practice in nursing. It will include information about how nurses can overcome these barriers. It will also illustrate the importance of utilising evidence informed practice to enhance the quality of service delivered within the healthcare profession.

Findings of evidenced based practice have to be disseminated to ensure that innovations for practice are replicated or applied in other settings by stakeholders in the health fraternity and healthcare professionals (Forsyth, Wright, Scherb & Gaspar, 2010). One of the objectives of dissemination should be to improve the practice. Dissemination of evidenced based practice findings in nursing is very critical in knowledge synthesis, translation, and translation. It is imperative in strengthening healthcare, informing policy, and improving practice decisions based on clinical evidence (Rycroft-Malone & Bucknall, 2010). This is realized by transforming clinical changes into practice. It actually involves two stage processes namely: translation of evidence into practice and integration of research recommendations into actual practice. Effective dissemination of evidence based practice findings enable staff to share information about developments in healthcare practice and implement innovation (Freemantle & Watt, 1994).

Sterile technique is required for insertion of an indwelling urinary catheter in the hospital setting, but clean technique can be used for intermittent catheterization in non-acute settings. By itself, sterile technique on insertion doesn't prevent UTI’s. Prevention of UTI’s depends on knowledge of causes, proper care techniques, and early catheter removal. Nurses are taught early on in school that sterile technique helps to reduce infections. It was drilled in our heads the entire time and now to have the evidence tell us that early catheter removal, along with proper technique good hand hygiene is the key to reduce UTI’s.

Evidence based practice is an important priority in nursing because it ensures that the best quality and most effective care is being used. Restraint use is an intervention that is being minimized more and more. It can be an important intervention when necessary but there are specific circumstances and guidelines that must be followed. Evidence based practice is proving that restraint use may be eliminated due to safety concerns and more beneficial interventions being used.

Within this essay Evidence based Practice will be identified and the significant effect it has on the nursing profession, barriers will also be explored in the implementation of Evidence Based Practice.

According to The American Nurses Association (ANA) Evidenced-based practice is a "scholarly and systematic problem-solving paradigm that results in the delivery of high quality healthcare" (American Nurses Association, 2010, p. 65). Through the use of evidence-based practice nurse and other health care professional have the ability to create clinical decisions, which allows clinical questions to be answered and aid in quality improvement. Furthermore creating a safe, efficient, productive environment for patients and staff that may result in improving patient outcomes and reduce expenses. Nursing research helps health care providers provide evidence-based practice, which may result in quality improvement (Rebar & Gersch, 2015).

The purpose of this essay will be to discuss evidence based practise and its use in nursing, I will be discussing, the types of research and various forms of data, including the principles of evidence based practise and research. Evidence Based practice is finding the most effective, research proven, evidence to make decisions regarding the service users individual needs and the best decisions for them. As David Sackett quotes, "evidence based practise is the integration of best research evidence with clinical expertise and patient values." (Sackett D, et al 1996, p.71) Evidence based practice is good practice, assist practitioners, avoiding information overload and applying the most useful information.

An evidence based practice, in my opinion, is the care provided to the patients based on the best evidences derived from the research. According to Hickson et.el (2013) an evidence based practice (EBP) is “the conscientious, explicit and judicious use of current best evidence in making decisions about the care of individual patients”. This definition recognizes three foundations of EBP such as the research evidence, expertness of the clinician and the client’s preferences and goals (Hickson, Laplante-Lévesque, & Wong, 2013).

In nursing, evidence based practice is the platform in which nursing skills and knowledge are built upon. Evidence based practice, as defined by the Academy of Medical-Surgical Nurses, is the “conscientious use of current best evidence in making decisions about patient care” (n.d.). The nurse, upon licensure, acknowledges the ability to facilitate patient care that incorporates all aspects of the evidence based practice model. In order for evidence-based practice to be maintained within health care institutions, it is essential that the nurse is able to function in manner that promotes best practice to provide effective, safe, high quality of care that is beneficial to the patient (Stevens, 2013).

The healthcare delivery system and the care for patients has brought new dimension which necessitated the need for competencies, perfection and accountability into the healthcare system. This has brought about a change in nursing education to now pay more attention to practical nursing. To affect better client’s outcome, knowledge must be applied clinically in a holistic way to the benefit of the patient we serve. Steven, K., (2013) in his article “The Impact of Evidence-Based Practice in Nursing and the Next Big Ideas”, suggests that, the recommendation that nurses lead delivery system and care bring to the fore that necessitate for new competencies, beyond evidence-based practice, that are requisite as nurses transform healthcare. Directions

Over the years nurses have relied on utilizing nursing interventions founded only on tradition. By following this trend nurses aren’t giving the best care, but the most popular care to patients. By choosing to care for patients using evidence based practice, nurses are giving the interventions they use credibility.

Today's nurses are expected to have critical thinking skills, be able to use research, and to continually seek out education to advance skills, knowledge and use of evidence-based nursing interventions. Evidence-based health care practices are available for a number of conditions such as asthma, heart failure, and diabetes. According to Sullivan (2013), “evidence based practice suggests that using research to decide on clinical treatments would improve quality of care, and that might be the case”. The book also mentions how there are obstacles that prevent nurses from following the evidence based practice procedure. These obstacles include lack of time, autonomy over their practice, ability to find and assess evidence and support from administration

Evidence based practice is based on evidence used to support practice and nurses must justify their rationale, it is now formed as an integral part of management, education, strategy and policy.